Provider Demographics
NPI:1700453545
Name:ALBARRACIN, ADRIAN JOSE
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:JOSE
Last Name:ALBARRACIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9452 JUNIPER MOSS CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6328
Mailing Address - Country:US
Mailing Address - Phone:305-877-8060
Mailing Address - Fax:
Practice Address - Street 1:9452 JUNIPER MOSS CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6328
Practice Address - Country:US
Practice Address - Phone:305-877-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9417002163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse